| Fernando Sanchez Clinical Neurophysiology Center Pa | |
|
2110 Lomas Del Sur Ste 111 Laredo TX 78046-5755 | |
| (956) 267-6630 | |
| (956) 552-6747 |
| Full Name | Fernando Sanchez Clinical Neurophysiology Center Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2110 Lomas Del Sur Ste 111, Laredo, Texas |
| Authorized Official Name and Position | Fernando Sanchez (PRESIDENT) |
| Authorized Official Contact | 9562676630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fernando Sanchez Clinical Neurophysiology Center Pa Po Box 451927 Laredo TX 78045-0047 Ph: (956) 267-6630 | Fernando Sanchez Clinical Neurophysiology Center Pa 2110 Lomas Del Sur Ste 111 Laredo TX 78046-5755 Ph: (956) 267-6630 |
| NPI Number | 1710360128 |
|---|---|
| Provider Enumeration Date | 07/02/2015 |
| Last Update Date | 04/05/2021 |
| Certification Date | 04/05/2021 |
| Medicare PECOS PAC ID | 3971892860 |
|---|---|
| Medicare Enrollment ID | O20160517000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710360128 | NPI | - | NPPES |
| 00463T | Other | MEDICARE PTAN | |
| 102580103 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | K3449 (Texas) | Primary |
| Provider Name | Fernando Sanchez Villasenor |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760595201 PECOS PAC ID: 8820077092 Enrollment ID: I20040721000438 |
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